Chloroquine-resistant Plasmodium Falciparum Research Articles

In Vitro and In Vivo Antimalarial Activities and Toxicological Assessment of Pogostemon Cablin (Blanco) Benth.

The aim of this study was to investigate the antimalarial activities and toxicity of Pogostemon cablin extracts. In vitro activities against the chloroquine-resistant Plasmodium falciparum K1 strain were assessed by using the Plasmodium lactate dehydrogenase enzyme (pLDH) assay, while in vivo activity against the Plasmodium berghei ANKA strain in mice was investigated using a 4-day suppressive test. The in vitro and in vivo toxicity were determined in Vero cells and mice, respectively. The ethanolic extract possessed antimalarial activity with an IC50 of 24.49 ± 0.01 µg/ml, whereas the aqueous extract showed an IC50 of 549.30 ± 0.07 µg/ml. Cytotoxic analyses of the ethanolic and aqueous extracts revealed a nontoxic effect on Vero cells at a concentration of 80 µg/ml. Based on a preliminary study of in vitro antimalarial activity, the ethanolic extract was chosen as a potential agent for further in vivo antimalarial activity analysis in mice. The ethanolic extract, which showed no toxic effect on mice at a dose of 2000 mg/kg body weight, significantly suppressed parasitemia in mice by 38.41%, 45.12% and 89.00% at doses of 200, 400 and 600 mg/kg body weight, respectively. In conclusion, this study shows that the ethanolic P. cablin extract possesses in vitro and in vivo antimalarial activity without toxic effects.

The Development of Novel Compounds Against Malaria: Quinolines, Triazolpyridines, Pyrazolopyridines and Pyrazolopyrimidines.

Based on medicinal chemistry tools, new compounds for malaria treatment were designed. The scaffolds of the drugs used to treat malaria, such as chloroquine, primaquine, amodiaquine, mefloquine and sulfadoxine, were used as inspiration. We demonstrated the importance of quinoline and non-quinoline derivatives in vitro with activity against the W2 chloroquine-resistant (CQR) Plasmodium falciparum clone strain and in vivo against Plasmodium berghei-infected mouse model. Among the quinoline derivatives, new hybrids between chloroquine and sulfadoxine were designed, which gave rise to an important prototype that was more active than both chloroquine and sulfadoxine. Hybrids between chloroquine–atorvastatin and primaquine–atorvastatin were also synthesized and shown to be more potent than the parent drugs alone. Additionally, among the quinoline derivatives, new mefloquine derivatives were synthesized. Among the non-quinoline derivatives, we obtained excellent results with the triazolopyrimidine nucleus, which gave us prototype I that inspired the synthesis of new heterocycles. The pyrazolopyrimidine derivatives stood out as non-quinoline derivatives that are potent inhibitors of the P. falciparum dihydroorotate dehydrogenase (PfDHODH) enzyme. We also examined the pyrazolopyridine and pyrazolopyrimidine nuclei.

Antiplasmodial Bis-Indole Alkaloids from the Bark of Flindersia pimenteliana.

Three new (1: -3: ) and 2 known (4: -5: ) bis-indole alkaloids were identified from the bark of Flindersia pimenteliana (Rutaceae). The structures of 1: -3: were elucidated on the basis of their (+)-HRESESIMS and 2D NMR spectroscopic data. Antiplasmodial activity for 1: -3: against chloroquine sensitive (3D7) and chloroquine-resistant (Dd2) Plasmodium falciparum is also reported, with IC50 values ranging from 0.96 to 2.41 µg/mL. These results expand our knowledge of the structure-activity relationships of potently antiplasmodial isoborreverine-type alkaloids, the bioactivity of which have recently attracted significant attention in the literature.

DNA recovery from archived RDTs for genetic characterization of Plasmodium falciparum in a routine setting in Lambar\xe9n\xe9, Gabon

BackgroundRapid diagnostic tests (RDTs) have been described as a source of genetic material to analyse malaria parasites in proof-of-concept studies. The increasing use of RDTs (e.g., in focal or mass screening and treatment campaigns) makes this approach particularly attractive for large-scale investigations of parasite populations. In this study, the complexity of Plasmodium falciparum infections, parasite load and chloroquine resistance transporter gene mutations were investigated in DNA samples extracted from positive RDTs, obtained in a routine setting and archived at ambient temperature.MethodsA total of 669 archived RDTs collected from malaria cases in urban, semi-urban and rural areas of central Gabon were used for P. falciparum DNA extraction. Performance of RDTs as a source of DNA for PCR was determined using: (i) amplification of a single copy merozoite surface protein 1 (msp1) gene followed by highly sensitive and automated capillary electrophoresis; (ii) genotyping of the pfcrt gene locus 72–76 using haplotype-specific-probe-based real-time PCR to characterize chloroquine resistance; and, (iii) real-time PCR targeting 18S genes to detect and quantify Plasmodium parasites.ResultsOut of the 669 archived RDTs, amplification of P. falciparum nucleic materials had a success rate of 97% for 18S real-time PCR, and 88% for the msp1 gene. The multiplicity of infections (MOI) of the whole population was 2.6 (95% CI 2.5–2.8). The highest number of alleles detected in one infection was 11. The MOI decreased with increasing age (β = − 0.0046, p = 0.02) and residence in Lambaréné was associated with smaller MOIs (p < 0.001). The overall prevalence of mutations associated with chloroquine resistance was 78.5% and was not associated with age. In Lambaréné, prevalence of chloroquine resistance was lower compared to rural Moyen-Ogooué (β = − 0.809, p-value = 0.011).ConclusionRDT is a reliable source of DNA for P. falciparum detection and genotyping assays. Furthermore, the increasing use of RDTs allows them to be an alternative source of DNA for large-scale genetic epidemiological studies. Parasite populations in the study area are highly diverse and prevalence of chloroquine-resistant P. falciparum remains high, especially in rural areas.

A CASE OF TROPICAL ILLNESS MANAGED IN THE MEDICAL ICU WITH AN INVESTIGATIONAL NEW DRUG

SESSION TITLE: Case Report Semifinalists 3 SESSION TYPE: Fellow Case Report Posters PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM INTRODUCTION: Rates of international travel are increasing along with increasing exposure to tropical diseases. It is of importance to maintain knowledge of common tropical diseases and treatment options. CASE PRESENTATION: A 30-year-old male, who returned a week prior from admission, from a vocational trip to Nigeria. Patient presented with symptoms of headache, fever, nausea, vomiting, abdominal pain and diarrhea. Patient was septic but otherwise hemodynamically stable, with presenting labs demonstrating profound thrombocytopenia with low haptoglobin (table 1) and presence of malaria on Wright-Giemsa stain. Blood smear demonstrated 17% Plasmodium Falciparum paracitemia. The Center of Disease Control(CDC) was contacted. Patient was started on treatment with intravenous(IV) quinidine and doxycycline and admitted to the Medical Intensive Care Unit(MICU) for further monitoring. Due to lack of available IV quinidine to complete therapy the decision was made to transition to IV artesunate and continued on doxycycline. Hospital course remained uncomplicated with quick resolution of parasitic loads (<1%). DISCUSSION: Malaria with Plasmodium Falciparum occurring in certain geographical areas, including Nigeria, are categorized by the CDC as a chloroquine resistant. Four applicable pharmacological therapies are available in such cases: atovaquone-proguanil, artemether-lumefantrine, quinine in combination with doxycycline, tetracycline or clindamycin and mefloquine. Quinine is the only FDA approved IV medication for treatment of severe malaria. The CDC defines severe malaria by the presence of one of more specifically defined clinical signs and symptoms and/or parasitemia of >5%. Our patient was stratified into a category of severe malaria by presence of a paracitemia of 17%. Per CDC recommendations severe malaria should be treated with IV antimalarial medication. World Health Organization recommends artesunate over quinine therapy for severe malaria. The FDA has approved artesunate as an investigational option in certain individuals who qualify. CONCLUSIONS: Artesunate is an effective alternative treatment option for individuals with severe malaria. We demonstrate a case of successful treatment of severe chloroquine resistant plasmodium falciparum malaria with artesunate. Reference #1: Centers for Disease Control and Prevention. (2018). Treatment of Malaria: Guidelines For Clinicians (United States) Reference #2: Dilip R. Karnad, MD, Guy A. Richards, MD PhD, Gisele Sampaio Silva, MD, Pravin Amin, MD. Tropical diseases in the ICU: A syndromic approach to diagnosis and treatment. Journal of Critical Care 46(2018)119-126 DISCLOSURES: No relevant relationships by Shozab Ahmed, source=Web Response No relevant relationships by Monika Kakol, source=Web Response

A High-Resolution Map of SBP1 Interactomes in Plasmodium falciparum-infected Erythrocytes.

SummaryThe pathogenesis of malaria parasites depends on host erythrocyte modifications that are facilitated by parasite proteins exported to the host cytoplasm. These exported proteins form a trafficking complex in the host cytoplasm that transports virulence determinants to the erythrocyte surface; this complex is thus essential for malaria virulence. Here, we report a comprehensive interaction network map of this complex. We developed authentic, unbiased, highly sensitive proteomic approaches to determine the proteins that interact with a core component of the complex, SBP1 (skeleton-binding protein 1). SBP1 interactomes revealed numerous exported proteins and potential interactors associated with SBP1 intracellular trafficking. We identified several host-parasite protein interactions and linked the exported protein MAL8P1.4 to Plasmodium falciparum virulence in infected erythrocytes. Our study highlights the complicated interplay between parasite and host proteins in the host cytoplasm and provides an interaction dataset connecting dozens of exported proteins required for P. falciparum virulence.

In vitro synergistic interaction of potent 4-aminoquinolines in combination with dihydroartemisinin against chloroquine-resistant Plasmodium falciparum

High-grade chloroquine (CQ) resistance has been reported in malaria endemic geographical regions such as Papua New Guinea, northern Papua, and eastern and western provinces of Indonesia, along with low-level resistance in Vietnam, South Korea, Turkey, Burma, South America, and Madagascar. Studies on CQ drug resistance have revealed the association of P. falciparum chloroquine resistance transporter protein. Thus, we are in dire need of alternate chemotherapeutic agents which in combination with artemisinin (or its analogues) are efficacious against chloroquine-resistant strains. Such combinations may thwart the emergence of drug resistant strains, along with reducing the malaria burden. Hypothesizing that newer 4-aminoquinolines, earlier reported by our group, could be part of a combination therapy to efficiently treat malaria, we sought to evaluate these compounds, viz. 1m, 1o, 2c, and 2j against the erythrocytic stages of Plasmodium falciparum, strain 3D7 (chloroquine-sensitive) and strain Dd2 (chloroquine-resistant), in combination with dihydroartemisinin (DHA). Results revealed substantially synergistic interactions between the combination partners, which could be further established by their potential to inhibit hemozoin formation with increased efficiency when combined, as compared to the compounds assessed individually. Furthermore, aminoquinolines and DHA show distinct stage-specific profiles. Our results stand in strong support of the potential of these aminoquinoline derivatives to serve as partner drugs in antimalarial combinations to treat multiple-drug-resistant Plasmodium strains.

Bioprospection for antiplasmodial activity, and identification of bioactive metabolites of native plants species from the Mata Atlântica biome, Brazil

A total of 33 extracts of eleven different plants species from Mata Atlântica biome, Brazil, and different fractions of the bioactive extracts were evaluated against chloroquine-resistant Plasmodium falciparum W2 strain by PfLDH method and cytotoxicity to HepG2 cells by the MTT assay, and chemically characterized by LC-DAD-ESI-MS/MS analysis. The results allowed the identification of Alchornea glandulosa, Miconia latecrenata, and Psychotria suterella as the most active plant species. Different flavonoids and tannins in Alchornea glandulosa and Miconia latecrenata besides alkaloids in Psychotria suterella were identified. Bioguided fractionation of A. glandulosa and M. latecrenata leaves extracts led to fractions exhibiting high parasite growth inhibition. Seven known alkaloids were identified in the P. suterella extract, and of these, only 5-carboxystrictosidine had been assayed for antiplasmodial activity what points to this species as the most promising among the eleven one assayed.

Antiplasmodial Activity and In Vivo Bio-Distribution of Chloroquine Molecules Released with a 4-(4-Ethynylphenyl)-Triazole Moiety from Organometallo-Cobalamins

We have explored the possibility of using organometallic derivatives of cobalamin as a scaffold for the delivery of the same antimalarial drug to both erythro- and hepatocytes. This hybrid molecule approach, intended as a possible tool for the development of multi-stage antimalarial agents, pivots on the preparation of azide-functionalized drugs which, after coupling to the vitamin, are released with a 4-(4-ethynylphenyl)-triazole functionality. Three chloroquine and one imidazolopiperazine derivative (based on the KAF156 structure) were selected as model drugs. One hybrid chloroquine conjugate was extensively studied via fluorescent labelling for in vitro and in vivo bio-distribution studies and gave proof-of-concept for the design. It showed no toxicity in vivo (zebrafish model) as well as no hepatotoxicity, no cardiotoxicity or developmental toxicity of the embryos. All 4-(4-ethynylphenyl)-triazole derivatives of chloroquine were equally active against chloroquine-resistant (CQR) and chloroquine-sensitive (CQS) Plasmodium falciparum strains.

A Comprehensive View on (-)-7-Oxo-ent-kaur-16-en-19-oic Acid, the Major Constituent of Xylopia sericea Leaves Extract: Complete NMR Assignments, X-Ray Crystallographic Structure, in Vitro Antimalarial Activity and Cytotoxicity.

Bioguided fractionation of Xylopia sericea antiplasmodial dichloromethane leaves extract led to the isolation of (-)-7-oxo-ent-kaur-16-en-19-oic acid (C20 H28 O3 ) that was identified by a combination of 1D and 2D NMR experiments (COSY, HMBC, HSQC, HSQC-TOCSY, HSQC-NOESY and NOESY) and by X-ray crystallography. A feature to be pointed out is its (4R) configuration that was inferred from the NOE experiments (HSQC-NOESY and NOESY) and X-ray crystallography. In vitro evaluation of this rare diterpene acid against the chloroquine-resistant strain Plasmodium falciparum W2 by the PfLDH method showed it disclosed a low antiplasmodial activity and was not cytotoxic to HepG2 cells (CC50 862.6±6.7 μm) by the MTT assay. The unequivocal NMR signals assignments, the X-ray crystallographic structure, the assessment to the bioactivities and the occurrence this diterpene in X. sericea are reported here for the first time.

An ortholog of Plasmodium falciparum chloroquine resistance transporter (PfCRT) plays a key role in maintaining the integrity of the endolysosomal system in Toxoplasma gondii to facilitate host invasion.

Toxoplasma gondii is an apicomplexan parasite with the ability to use foodborne, zoonotic, and congenital routes of transmission that causes severe disease in immunocompromised patients. The parasites harbor a lysosome-like organelle, termed the "Vacuolar Compartment/Plant-Like Vacuole" (VAC/PLV), which plays an important role in maintaining the lytic cycle and virulence of T. gondii. The VAC supplies proteolytic enzymes that contribute to the maturation of invasion effectors and that digest autophagosomes and endocytosed host proteins. Previous work identified a T. gondii ortholog of the Plasmodium falciparum chloroquine resistance transporter (PfCRT) that localized to the VAC. Here, we show that TgCRT is a membrane transporter that is functionally similar to PfCRT. We also genetically ablate TgCRT and reveal that the TgCRT protein plays a key role in maintaining the integrity of the parasite’s endolysosomal system by controlling morphology of the VAC. When TgCRT is absent, the VAC dramatically increases in volume by ~15-fold and overlaps with adjacent endosome-like compartments. Presumably to reduce aberrant swelling, transcription and translation of endolysosomal proteases are decreased in ΔTgCRT parasites. Expression of subtilisin protease 1 is significantly reduced, which impedes trimming of microneme proteins, and significantly decreases parasite invasion. Chemical or genetic inhibition of proteolysis within the VAC reverses these effects, reducing VAC size and partially restoring integrity of the endolysosomal system, microneme protein trimming, and invasion. Taken together, these findings reveal for the first time a physiological role of TgCRT in substrate transport that impacts VAC volume and the integrity of the endolysosomal system in T. gondii.

Bridged bicyclic 2,3-dioxabicyclo[3.3.1]nonanes as antiplasmodial agents: Synthesis, structure-activity relationships and studies on their biomimetic reaction with Fe(II)

Despite recent advancements in its control, malaria is still a deadly parasitic disease killing millions of people each year. Progresses in combating the infection have been made by using the so-called artemisinin combination therapies (ACTs). Natural and synthetic peroxides are an important class of antimalarials. Here we describe a new series of peroxides synthesized through a new elaboration of the scaffold of bicyclic-fused/bridged synthetic endoperoxides previously developed by us. These peroxides are produced by a straightforward synthetic protocol and are characterized by submicromolar potency when tested against both chloroquine-sensitive and chloroquine-resistant Plasmodium falciparum strains. To investigate their mode of action, the biomimetic reaction of the representative compound 6w with Fe(II) was studied by EPR and the reaction products were characterized by NMR. Rationalization of the observed structure-activity relationship studies was performed by molecular docking. Taken together, our data robustly support the hypothesized mode of activation of peroxides 6a-cc and led to the definition of the key structural requirements responsible for the antiplasmodial potency. These data will pave the way in future to the rational design of novel optimized antimalarials suitable for in vivo investigation.

Two new antiplasmodial flavonolignans from the leaves of Cecropia obtusifolia

Cecropia species are traditionally used in several Latin American countries to treat various diseases including malaria. A phytochemical investigation on the leaves of Cecropia obtusifolia Bertol (Urticaceae) afforded two new flavonolignans, i.e. ent-mururin A (1) and ent-vaccinin A (2). They were isolated by means of chromatographic techniques and elucidated based on their spectroscopic (NMR, MS and optical rotation) data, and were described as new isomers of mururin A and vaccinin A. Antiplasmodial evaluation revealed that 1 and 2 were moderately active in vitro against the chloroquine-resistant strain Plasmodium falciparum K1 (IC50 4.68 μM and 7.34 μM, respectively) without cytotoxic effects up to a concentration of 64.0 μM.

Prevalence of Mutant Alleles Responsible for Chloroquine Resistance among Plasmodium falciparum Isolates in North Central, Nigeria

Background: Although chloroquine (CQ) has been officially replaced with artemisinin combination therapy (ACT) as first line drug for the treatment of malaria in Nigeria since 2005, a lot of people still believe that chloroquine is more effective chiefly because of the decline in the sensitivity of Plasmodium falciparum to ACT. Thus resulting into unofficial use of CQ for self medication. This study was conducted in order to survey the current status of chloroquine resistant strains of pfcrt and pfmdr1 in view of possible re-introduction of chloroquine for malaria treatment.&#x0D; Methods: DNA was extracted from one hundred (100) microscopically confirmed Plasmodium falciparum positive blood samples spotted on 3 mm Whatman filter paper. The detection of mutations in Plasmodium falciparum chloroquine resistance transporter (Pfcrt) and Plasmodium falciparum multidrug resistance (Pfmdr1) genes was performed by nested polymerase chain reaction (PCR) followed by restriction fragment length polymorphism (RFLP).&#x0D; Results: Results showed the presence of mutant alleles of Pfcrt and Pfmdr1 in 60% and 41% of the samples respectively. However, there was no significant correlation in the prevalence of mutant alleles (T76/Y86) in relation to gender (p = 0.59/ 0.08) and age (p=0.59/0.93) of participants respectively.&#x0D; Conclusion: The observed high prevalence of chloroquine resistance despite thirteen years of withdrawal calls for serious concern.

Acrotrione: An Oxidized Xanthene from the Roots of Acronychia pubescens.

A new oxidized xanthene, acrotrione (1), and two known acetophenones (2 and 3) were isolated from a methanol extract of the roots of Acronychia pubescens. The structure of 1 was elucidated on the basis of its (+)-HRESIMS, 2D NMR, and ECD data. Acritrione(1) contains an unusual oxidized furo[2,3- c]xanthene moiety that has not been previously reported. Moderate antiplasmodial activity for these natural products against chloroquine-sensitive (3D7) and chloroquine-resistant (Dd2) Plasmodium falciparum was determined with IC50 values ranging from 1.7 to 4.7 μM.

Phytochemistry and antiplasmodial activity of Xylopia sericea leaves

Aiming to investigate the antiplasmodial activity and the phytochemical composition of Xylopia sericea leaves, the essential oil and dichloromethane extract were analyzed by gas and liquid chromatography, respectively, both of them coupled to mass spectrometry, and were evaluated against the chloroquine-resistant Plasmodium falciparum strain (W2) and for cytotoxicity to HepG2 cells. Low growth inhibition of P. falciparum as well as low cytotoxicity to HepG2 cells were observed for the essential oil. The leaves dichloromethane extract showed moderate growth inhibition of P. falciparum and low cytotoxicity to HepG2 cells. Bioguided chromatographic fractionation of this extract led to fractions with increased antiplasmodial activity from which liriodenine (IC50 6.1 ± 0.1 μg/mL, CC50 > 1000.0 μg/mL, SI > 164), an aporphine alkaloid, and an acetogenin-rich fraction containing mainly isomers of annomontacin and 4-deoxy-annomontacin (IC50 22.7 ± 1.9 µg/mL, CC50 336.1 ± 15.5 µg/mL, SI = 15) might be highlighted for their antiplasmodial activity.

Synthesis, characterization, and evaluation of silver(I) complexes with mixed-ligands of thiosemicarbazones and diphenyl(p-tolyl)phosphine as biological agents

Five new silver(I) complexes were synthesized with mixed ligands of thiosemicarbazone derivatives and diphenyl(p-tolyl)phosphine in search of new biologically active compounds. A CHN elemental analysis, powder X-ray diffraction (PXRD) data and several spectroscopic techniques such as Fourier-transform infrared spectroscopy, energy-dispersive X-ray, 1H, 13C, and 31P{1H} NMR were performed to elucidate the structure of these complexes. Elemental analysis suggested that the stoichiometry of the complexes formed by the reaction of silver nitrate with thiosemicarbazone in the presence of (p-tolyl)PPh2 was indeed 1:2:1 molar ratio. The silver ions were discovered to be coordinated to the sulfur of thiosemicarbazone and phosphorus of (p-tolyl)PPh2, having a tetrahedral geometry based on the spectroscopic data obtained. The PXRD patterns were studied to see the degree of crystallinity of the complexes. The in vitro antiproliferative activity of these complexes was investigated toward the MDA-MB-231 and MCF-7 breast cancer cell lines, as well as the HT-29 colon cancer cell line, which yielded IC50 values in low micromolar range. The antiplasmodial activity of these complexes was also examined against chloroquine-resistant Plasmodium falciparum parasite which demonstrated good activity and further tested for their selectivity index.

In vitro and in vivo antiplasmodial activity of extracts and isolated constituents of Alstonia congensis root bark

Ethnopharmacological relevanceAn aqueous decoction of root bark of Alstonia congensis Engl. (Apocynaceae) is used in several African countries to treat various ailments including malaria. Materials and methodsExtracts of different polarity and isolated constituents were tested in vitro for their antiplasmodial activity against the chloroquine-resistant strain Plasmodium falciparum K1 and the chloroquine-sensitive strain P. falciparum NF54A19A, as well as for their cytotoxic effects againt MRC-5 cells (human lung fibroblasts). Extracts and fractions were evaluated in vivo against the chloroquine-resistant strain P. yoelii N67 and the chloroquine-sensitive strain P. berghei berghei ANKA. ResultsThe aqueous extract, the 80% methanol extract and the alkaloid-enriched extract exhibited strong antiplasmodial activity against P. falciparum K1 with IC50 values < 10 µg/ml and against P. falciparum NF54 A19A with IC50 values < 0.02 µg/ml. In vivo against P. yoelii N67, at the highest oral dose of 400 mg/kg body weight, all extracts produced 70–73% chemosuppression, while against P. berghei berghei, more than 75% chemosuppression was observed. With regard to the isolated constituents, boonein was inactive in vitro against P. falciparum K-1 (IC50 > 64 µM), while echitamine, 6,7-seco-angustilobine B and β-amyrin exhibited moderate activity (IC50 < 30 µM). Against P. falciparum NF54 A19A, boonein was inactive (IC50 > 64 µM), while echitamine, 6,7-secoangustilobine and β-amyrin showed moderate IC50 values of 11.07, 21.26 and 40.70 µM, respectively. ConclusionThese results demonstrated that all extracts from A. congensis root bark possessed antiplasmodial activity in vitro and in vivo. They can be used as raw materials for the preparation of ameliorated remedies for the treatment of uncomplicated malaria. The observed antiplasmodial activity may be due in part to the presence of indole alkaloids.

HPLC-DAD-SPE-NMR isolation of tetracyclic spiro-alkaloids with antiplasmodial activity from the seeds of Erythrina latissima

Seven tetracyclic spiro-alkaloids, i.e. glucoerysodine (1), erysodine (2), epi-erythratidine (3), erysovine (4), erythratidine (5), erysotrine (6) and erythraline (7) were isolated from the seeds of Erythrina latissima by means of conventional separation methods and HPLC-DAD-SPE-NMR. Their structures were elucidated by spectroscopic means. This is the first report on the isolation of compounds 3, 5 and 6 from this plant. Antiplasmodial activity against the chloroquine-resistant strain Plasmodium falciparum K1 and cytotoxicity against MRC-5 cells (human fetal lung fibroblast cells) was assessed in vitro. Erysodine (2) and erysovine (4) showed moderate activity (IC50 6.53 µM and 4.05 µM, respectively), compared with the standard chloroquine (IC50 = 0.14 µM). No cytotoxicity was observed in a concentration up to 64.0 µM.

Treatment Outcome Analysis of Artemisinin based Therapy in Plasmodium falciparum Infection: An Observational Study

Currently, the preferred treatment for chloroquine (CQ) resistant Plasmodium falciparum (Pf) is Artemisinin combination therapy (ACT). Our aim was to assess the artemisinin based treatment outcomes in patients with Plasmodium falciparum infection. Patients with falciparum infection from a tertiary health care centre in South India were enrolled in this study. It was a non-randomised observational study .The data regarding peripheral blood smear, complete blood count, liver, renal function tests and the treatment given was documented at admission and on the day of discharge. Patients with uncomplicated falciparum malaria were most common. Artesunate and doxycycline was the most common combination used at our centre (54.6%) followed by artemether –lumefantrine. All patients had peripheral smear negative for Plasmodium falciparum parasite by the end of treatment. There was improvement in blood count,liver and renal function tests. Artemisinin based combination therapy was effective in treatment of falciparum malaria.